You’ve been at XYZ Hospital for four years now. You feel like you’ve excelled as a staff therapist and you just found out one of your supervisors will be moving out of state. Should you go into your boss and ask to be promoted to her position?

AARC members with a long history of management experience under their belts say that’s a slippery slope.

Be ready with specificsEd Fluker, RRT, administrative director of respiratory care at Florida Hospital in Orlando, says he generally doesn’t mind people being candid about their career goals and he encourages members of his team to feel safe in discussing any topic they want with him. That said, if they do plan to ask for a promotion, he would prefer they come to him prepared to talk about specifics.

“If they ask, they need to be willing to discuss the position of interest, why they feel they are prepared or qualified, and how the step would fit into their long-term goals,” says the manager. He also expects people with this type of request to schedule a formal meeting with him to address the issue. “Chance meetings in the hallway are not a good time to discuss career goals and aspirations,” he says. “I would prefer they arrange to meet with me so we have the appropriate time to discuss their goals appropriately.”

He also notes that his department does intentional quarterly employee rounding, and that could be a good time for the individual to bring up career goals like promotions too. And he emphasizes that just asking doesn’t mean it’s going to happen. “I have had people ask about promotions, but we follow an appropriate process to include any interested and qualified individuals when determining advancements.”

Red flags can be raisedAllen Wentworth, MEd, RRT, FAARC, director of the WELLS Center, respiratory care, ancillary health technicians, pulmonary diagnostics, and pulmonary rehabilitation at the University of Colorado Hospital in Denver, welcomes employees to discuss potential promotions with him as well. But while he appreciates their enthusiasm for getting ahead in the profession, such a discussion raises some red flags too—particularly if the staff member is relatively new in the department.

“In my mind I wonder a list of things,” he says. ”Did we just hire someone that will leave at the first opportunity that opens up in that requested position at another facility? Why would they accept a job that didn’t meet their career aspirations? Were they just desperate to get a job? Do they have the skills or experience to match the position for which they would like to promoted?”

He feels better about employees who ask about their chances for advancement in a way that demonstrates they are willing to work within the existing organizational framework to eventually meet their career goals. “We would like for them to state that they appreciate the opportunity to work in the department and would like to continue to get a feel for the culture.” Over-confidence in one’s abilities and a lack of humility will nearly always be a turn off for him, especially among staff members who have not been on staff all that long.

Like Fluker, Wentworth has had employees ask him for a promotion before, and says he typically does like to promote from within. But most of the time, he already knows which of his staff will be likely candidates without anyone having to ask. “I like to watch how individuals relate to co-workers, nurses, physicians, and most importantly, patients and families,” says the manager. “In order for a leadership position to be effective one must establish trust and credibility. I feel it’s easier when trust and credibility have already been established to move somebody into a leadership position.”